Antibiotic Conjugates

ABSTRACT

The present invention describes antibiotic conjugates. These single drug entities are formed connecting one antibiotic with another antibiotic. Upon topical application to the eye, the conjugate hybrid would undergo enzymatic and/or hydrolytic cleavage to release the individual drugs.

RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Patent Application Ser. No. 61/775,216 filed Mar. 8, 2013, the disclosure of which is hereby incorporated in its entirety herein by reference.

FIELD OF THE INVENTION

The present invention describes antibiotic conjugates. These single drug entities are formed by connecting one antibiotic with another antibiotic via a linker or no linker. Upon topical application to the eye, the conjugate hybrid would undergo enzymatic and/or hydrolytic cleavage to release the individual drugs.

SUMMARY OF THE INVENTION

Due to increasing bacterial resistance to antibiotics there is a constant need for antibiotic compounds. A conjugate drug, also referred to as a co-drug, a pro-drug, or a hybrid drug, comprises two or more different or same drugs within one single chemical entity wherein each drug contains an appropriate chemical functionality to enable them to be connected together, either directly or by means of a covalent linker, which is cleavable and biologically labile. Hybrid drugs may incorporate at least two drugs joined together by a linker moiety such as an ester, a carboxylate, a carbonyl, a carbonate, an amido, a carbamate, a ketone, an amino, an oxo, an ethylene glycol, an alkylene, a polyethylene glycol, which is cleaved enzymatically or hydrolytically in vivo to release the active drugs.

By appropriate structural design of these linkers, it may be possible to control the release of each drug. When the drugs are chemically combined, the resulting hybrid drug will usually has different physicochemical properties compared to the individual parent drugs, which may provide superior properties for delivery when compared to delivery of a physical mixture of the drugs. The antibiotic moieties, of the compounds disclosed herein are connected each separately via a covalent bond to a linker such that said compound degrades in vivo to yield the individual antibiotics.

Degradation of these covalent bonds generally, yields the corresponding carboxylic acid, or alcohol, or amine by hydrolysis or by a related reaction. A compound which degrades in vivo to yield the individual antibiotics, produces the active antibiotic drugs at some point in the metabolic process of the claimed compound. The linker structure may be designed such that cleavage at a single covalent bond initiates a cascade of reactions that results in the ultimate release of the antibiotic drugs.

DETAILED DESCRIPTION OF THE INVENTION

The hybrid drugs of the invention provide a unique delivery of two antibiotics for the treatment and prevention of ophthalmic bacterial infections. A single drug entity is advantageous to individual dosing of each drug because of the ability for simultaneous dosing and elimination of washout concerns when applying each drug separately.

The hybrid drugs of the invention have anti-bacterial activity and are very useful compounds capable of producing the effect of an antibacterial drug with a broad range of activity in monotherapy.

The use of an antibiotic hybrid drug is indicated where the risk of infection is high or where there is an expectation that potentially dangerous numbers of bacteria will be present in the eye. The composition is useful in treating inflammation associated with bacterial infections and inflammation resulting from surgical procedures where the risk of bacterial infection is high. The composition is also useful in post-operative inflammation where there is an increased chance of bacterial infection. The composition of the invention may also be used prophylactically in connection with various ophthalmic surgical procedures that create a risk of bacterial infection. Other examples of ophthalmic conditions which may be treated with the compositions of the present invention include infective conditions associated with inflammation and where the use of anti-inflammatory is acceptable. Such conditions may include, but are not limited to conjunctivitis, keratitis, blepharitis, endophthalmitis, dacyrocystitis, hordeolum, corneal ulcers, anterior blepharitis, posterior blepharitis, meibomian gland dysfunction, dry eye disease (keratocojunctivitis sicca) ocular pain, red eye, hyperemia, ocular pain and inflammation post-ocular surgery, bacterial conjunctivitis, anterior uveitis, post-surgical inflammation, inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe, such as allergic conjunctivitis, ocular rosacea, blepharitis, meibomian gland dysfunction, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitis, corneal injury from chemical radiation, or thermal burns, penetration of foreign bodies, allergy, and combinations thereof.

The present invention relates to hybrid drugs comprising at least two antibiotics, or a pharmaceutical salt thereof, which are separately connected via a covalent bond to a linker or directly to each other, such that said covalent bonds degrade in vivo to yield the respective two antibiotics independently.

In another aspect the invention relates to hybrid drugs comprising at least two same antibiotics, which are separately connected via a covalent bond to a linker such that said covalent bonds degrade in vivo to yield the respective antibiotics independently.

In another aspect the invention relates to hybrid drugs comprising at least two same antibiotics, which are connected via two covalent bonds directly to each other such that said covalent bonds degrade in vivo to yield the respective antibiotics independently.

In another aspect the invention relates to hybrid drugs comprising at least two different antibiotics, which are connected via two covalent bonds to a linker such that said covalent bonds degrade in vivo to yield the respective antibiotics independently.

In another aspect the invention relates to hybrid drugs comprising at least two different antibiotics, which are connected via two covalent bonds directly to one another such that said covalent bonds degrade in vivo to yield the respective antibiotics independently.

Depending of the bond formation site, the antibiotics can be linked via an ester bond or via an amido bond, as shown in the following schemes:

The hybrid drugs disclosed herein comprise antibiotics moieties belonging to distinct classes: fluoroquinolones, cephalosporins, chloramphenicol, aminoglycosides, penicillins, erythromycin, macrolide antibiotics and oxazolidionones.

Fluoroquinolones include, but are not limited to: levofloxacin, moxifloxacin, gatifloxacin, gemifloxacin, trovafloxacin, ofloxacin, ciprofloxacin, sparfloxacin, grepafloxacin, norfoxacin, enoxacin, lomefloxacin, fleroxacin, tosufloxacin, prulifloxacin, pazufloxacin, clinafloxacin, garenoxacin, and sitafloxacin.

Cephalosporins include, but are not limited to: loracarbef, cephalexin, cefuroxime, ceftriaxone, ceftaxime, ceftizoxime, ceftibuten, ceftazidime, cefprozil, cefpodoxime, cefoxitin, cefotetan, cefotaxime, cefoperazone, cefixime, cefepime, cefditoren, cefdinir, cefoperaxone, moxalactam, cefazolin, cefamandole, cefadroxil, cefaclor, cephalothin, cephradine, cephacetrile, and cephalothin.

Aminoglycosides include, but are not limited to: tobramycin, streptomycin, gentamicin, kanamycin, amikacin and netilmicin.

Penicillins include, but are not limited to: penicillin G, ticarcillin, methicillin, phenthicillin, cloxacillin, dicloxacillin, nafcillin, oxacillin.

Macrolide antibiotics include, but are not limited to: erythromycin and azithromycin.

Oxazolidinones include, but are not limited to: linezolid.

In another embodiment the compounds disclosed herein comprise at least two antibiotic drug moieties selected from levofloxacin, moxifloxacin, gatifloxacin, gemifloxacin, trovafloxacin, ofloxacin, ciprofloxacin, sparfloxacin, grepafloxacin, norfoxacin, enoxacin, lomefloxacin, fleroxacin, tosufloxacin, prulifloxacin, pazufloxacin, clinafloxacin, garenoxacin, sitafloxacin, loracarbef, cephalexin, cefuroxime, ceftriaxone, ceftaxime, ceftizoxime, ceftibuten, ceftazidime, cefprozil, cefpodoxime, cefoxitin, cefotetan, cefotaxime, cefoperazone, cefixime, cefepime, cefditoren, cefdinir, cefoperaxone, moxalactam, cefazolin, cefamandole, cefadroxil, cefaclor, cephalothin, cephradine, cephacetrile, cephalothin, chloramphenicol, tobramycin, streptomycin, gentamicin, kanamycin, amikacin, netilmicin, penicillin g, ticarcillin, methicillin, phenthicillin, cloxacillin, dicloxacillin, nafcillin, oxacillin, erythromycin and zythromycin.

In another embodiment the compounds disclosed herein comprise at least one pro-drug moiety and at least two antibiotic drug moieties selected from: levofloxacin, moxifloxacin, gatifloxacin, gemifloxacin, trovafloxacin, ofloxacin, ciprofloxacin, sparfloxacin, grepafloxacin, norfoxacin, enoxacin, lomefloxacin, fleroxacin, tosufloxacin, prulifloxacin, pazufloxacin, clinafloxacin, garenoxacin, sitafloxacin, loracarbef, cephalexin, cefuroxime, ceftriaxone, ceftaxime, ceftizoxime, ceftibuten, ceftazidime, cefprozil, cefpodoxime, cefoxitin, cefotetan, cefotaxime, cefoperazone, cefixime, cefepime, cefditoren, cefdinir, cefoperaxone, moxalactam, cefazolin, cefamandole, cefadroxil, cefaclor, cephalothin, cephradine, cephacetrile, cephalothin, chloramphenicol, tobramycin, streptomycin, gentamicin, kanamycin, amikacin, netilmicin, penicillin g, ticarcillin, methicillin, phenthicillin, cloxacillin, dicloxacillin, nafcillin and oxacillin.

In another embodiment the compounds disclosed herein comprise at least one linker and at least two antibiotic drugs selected from levofloxacin, moxifloxacin, gatifloxacin, gemifloxacin, trovafloxacin, ofloxacin, ciprofloxacin, sparfloxacin, grepafloxacin, norfoxacin, enoxacin, lomefloxacin, fleroxacin, tosufloxacin, prulifloxacin, pazufloxacin, clinafloxacin, garenoxacin, sitafloxacin, loracarbef, cephalexin, cefuroxime, ceftriaxone, ceftaxime, ceftizoxime, ceftibuten, ceftazidime, cefprozil, cefpodoxime, cefoxitin, cefotetan, cefotaxime, cefoperazone, cefixime, cefepime, cefditoren, cefdinir, cefoperaxone, moxalactam, cefazolin, cefamandole, cefadroxil, cefaclor, cephalothin, cephradine, cephacetrile, cephalothin, chloramphenicol, tobramycin, streptomycin, gentamicin, kanamycin, amikacin, netilmicin, penicillin g, ticarcillin, methicillin, phenthicillin, cloxacillin, dicloxacillin, nafcillin and oxacillin. In another embodiment the compounds disclosed herein comprise one linker and a pro-drug moiety and at least two antibiotic drugs selected from levofloxacin, moxifloxacin, gatifloxacin, gemifloxacin, trovafloxacin, ofloxacin, ciprofloxacin, sparfloxacin, grepafloxacin, norfoxacin, enoxacin, lomefloxacin, fleroxacin, tosufloxacin, prulifloxacin, pazufloxacin, clinafloxacin, garenoxacin, sitafloxacin, loracarbef, cephalexin, cefuroxime, ceftriaxone, ceftaxime, ceftizoxime, ceftibuten, ceftazidime, cefprozil, cefpodoxime, cefoxitin, cefotetan, cefotaxime, cefoperazone, cefixime, cefepime, cefditoren, cefdinir, cefoperaxone, moxalactam, cefazolin, cefamandole, cefadroxil, cefaclor, cephalothin, cephradine, cephacetrile, cephalothin, chloramphenicol, tobramycin, streptomycin, gentamicin, kanamycin, amikacin, netilmicin, penicillin g, ticarcillin, methicillin, phenthicillin, cloxacillin, dicloxacillin, nafcillin and oxacillin.

In another embodiment the compounds disclosed herein comprise one linker and a pro-drug moiety and at least two antibiotic drugs selected from: gatifloxacin, moxifloxacin, tobramycin, clindamycin, chloramphenicol, linozolid and amikacin.

In another embodiment the compounds disclosed herein comprise a pro-drug moiety and at least two antibiotic drugs selected from: gatifloxacin, moxifloxacin, tobramycin, clindamycin, chloramphenicol, linozolid and amikacin. In another embodiment the compounds disclosed herein comprise one linker and at least two antibiotic drugs selected from: gatifloxacin, moxifloxacin, tobramycin, clindamycin, chloramphenicol, linozolid and amikacin. In another embodiment the compounds disclosed herein comprise at least two antibiotic drugs selected from: gatifloxacin, moxifloxacin, tobramycin, clindamycin, chloramphenicol, linozolid and amikacin.

In another aspect the invention provides compounds which may comprise a linker moiety selected from, but not limited to, an ester, a carboxylate, a carbonyl, a carbonate, an amido, a carbamate, a ketone, an amino, an oxo, an ethylene glycol, a polyethylene glycol, an ethylene.

In another aspect, the invention provides compounds which may comprise a linker moiety comprising any combination of an ester, a carboxylate, a carbonyl, a carbonate, an amido, a carbamate, a ketone, an ethylene, an amino, an oxo, an ethylene glycol and/or a polyethylene glycol. Such linker moieties are exemplified below and linker structures are exemplified in Table 1.

Examples of ester moieties comprised in the linkers are:

Examples of carboxylate moieties comprised in the linkers are:

Example of a carbonyl moiety comprised in the linkers is

Example of a carbonate moiety comprised in the linkers is:

Examples of amido moieties comprised in the linkers are:

Example of carbamate moiety comprised in the linkers is:

Example of a ketone moiety comprised in the linkers is:

Examples of amino moieties comprised in the linkers are:

Example of an oxo moiety comprised in the linker is:

Example of ethylene glycol moieties comprised in the linkers are:

Example of polyethylene glycol moiety comprised in the linkers is:

In another embodiment, the compounds disclosed herein comprise gatifloxacin and moxifloxacin, such as:

-   1-cyclopropyl-7-(4-{[({[1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinolin-3-yl]carbonyl}oxy)methoxy]carbonyl}-3-methylpiperazin-1-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid.

In another embodiment, the compounds disclosed herein comprise gatifloxacin and tobramycin, such as:

-   [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl     rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; -   rel-7-[4-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4-oxobutanoyl)oxy]methoxy}carbonyl)-3-methylpiperazin-1-yl]-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid; -   [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl({[1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinolin-3-yl]carbonyl}oxy)methyl     rel-butanedioate.

In another embodiment, the compounds disclosed herein comprise moxifloxacin and tobramycin, such as:

-   [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl     rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; -   rel-7-[1-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4-oxobutanoyl)oxy]methoxy}carbonyl)octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl]-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid.

In another embodiment, the compounds disclosed herein comprise moxifloxacin and clindamycin, such as:

-   (2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl     1-cyclopropyl-6-fluoro-7-(hexahydro-1H-pyrrolo[3,4-b]pyridin-6(2H)-yl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylate.

In another embodiment, the compounds disclosed herein comprise chloramphenicol and clindamycin, such as:

-   4-(((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl)oxy)-4-oxobutyl(2-(2,2-dichloroacetamido)-3-hydroxy-3-(4-nitrophenyl)propyl)succinate; -   1-((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl)     5-(3-(2,2-dichloroacetamido)-3-hydroxy-2-(4-nitrophenyl)propyl)     2-aminopentanedioate; -   (2R,3R)-6-(2-chloro-1-{[(1-methyl-4-propylpyrrolidin-2-yl)carbonyl]amino}propyl)-4,5-dihydroxy-2-(methylsulfanyl)tetrahydro-2H-pyran-3-yl(3S)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl     rel-butanedioate; -   (2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl(2-(2,2-dichloroacetamido)-3-hydroxy-3-(4-nitrophenyl)propyl)terephthalate; -   2-amino-3-(2-(2,2-dichloroacetamido)-3-hydroxy-3-(4-nitrophenyl)propoxy)-3-oxopropyl((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl)succinate.

In another embodiment, the compounds disclosed herein comprise gatifloxacin and clindamycin, such as:

-   7-(4-((((4-(((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl)oxy)-4-oxobutanoyl)oxy)methoxy)carbonyl)-3-methylpiperazin-1-yl)-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid; -   (2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl     1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate.

In another embodiment, the compounds disclosed herein comprise chloramphenicol and gatifloxacin, such as:

-   rel-1-cyclopropyl-7-(4-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4-nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan-1-oyl}-3-methylpiperazin-1-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid, -   ({[1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinolin-3-yl]carbonyl}oxy)methyl(2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl     rel-butanedioate; -   (2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl     rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate.

In another embodiment, the compounds disclosed herein comprise chloramphenicol and moxifloxacin, such as:

-   rel-1-cyclopropyl-7-(1-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4-nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan-1-oyl}octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid; -   (2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl     rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; -   rel-1-cyclopropyl-7-(1-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4-nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan-1-oyl}octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid.

In another embodiment, the compounds disclosed herein comprise chloramphenicol and linozolid, such as:

-   {[acetyl({(5R)-3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3-oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl(2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl     rel-butanedioate.

In another embodiment, the compounds disclosed herein comprise moxifloxacin and linozolid, such as:

-   {[acetyl({3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3-oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl     1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate.

In another embodiment, the compounds disclosed herein comprise gatifloxacin and linozolid, such as:

-   {[acetyl({3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3-oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl     1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate.

In another embodiment, the compounds disclosed herein comprise gatifloxacin and amikacin, such as:

-   rel-7-[4-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4-amino-6-{[(2S)-4-amino-2-hydroxybutanoyl]amino}-3-{[(2R,3R,4S,5S,6R)-6-(aminomethyl)-3,4,5-trihydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4-oxobutanoyl)oxy]methoxy}carbonyl)-3-methylpiperazin-1-yl]-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic     acid; -   [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4-amino-6-{[(2S)-4-amino-2-hydroxybutanoyl]amino}-3-{[(2R,3R,4S,5S,6R)-6-(aminomethyl)-3,4,5-trihydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl     rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate.

Further the compounds disclosed herein may comprise a linker selected from Table 1:

TABLE 1 Linker Number Linker Structure n = 0 n = 1 n = 2 n = 3

L2 L1

L3

L4

L5

L6

L7

L14

L15

L16

L46 L17

L8

L9

L10

L18

L11

L19

L12

L13

L20

L21

L22

L23

L24

L25

L26

L27

L28

L29

L30

L31

L32

L33

L34

L35

L36

L37

L38

L39

L40

L41

L42

L43

L44

L45

L47

L48

L49

L50

L51

L52

L53

L54

L55

L56

L57

L58

L59

L60

L61

L62

L63

L64

L65

L66

L67

L68 L114 L115

L69

L70

L71

L72

L73

L74

L75

L76

L77

L78

L79

L80

L81

L82

L83

L84

L85 L86

L87

L88

L89

L90

L91

L92

L93

L94

L95

L96

L97

L98

L99 L100 L101

L102

L103

L104

L105

L106

L107

L108

L109

L110

L111

L112

L113

Further, the hybrid drugs of the invention may comprise a pro-drug moiety as described below in Table 2:

TABLE 2 Pro-drug Moiety Pro-drug Moiety Structure Number

P1

P2

P3

P4

P5

P6

P7

P8

P9

P10

P11

P12

P13

P14

P15

Compounds of the invention are shown in Table 3.

TABLE 3 Compound number IUPAC NAME 15 2-amino-3-(2-(2,2-dichloroacetamido)-3-hydroxy-3-(4- nitrophenyl)propoxy)-3-oxopropyl ((2R,3R,4S,5R,6R)-6-((1S)-2- chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)- 4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl) succinate 14 (2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4- propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2- (methylthio)tetrahydro-2H-pyran-3-yl (2-(2,2-dichloroacetamido)- 3-hydroxy-3-(4-nitrophenyl)propyl) terephthalate 11 4-(((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methy1-4- propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2- (methylthio)tetrahydro-2H-pyran-3-yl)oxy)-4-oxobutyl (2-(2,2- dichloroacetamido)-3-hydroxy-3-(4-nitrophenyl)propyl) succinate 12 1-((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4- propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2- (methylthio)tetrahydro-2H-pyran-3-yl) 5-(3-(2,2- dichloroacetamido)-3-hydroxy-2-(4-nitrophenyl)propyl) 2- aminopentanedioate 16 (2S,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4- propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2- (methylthio)tetrahydro-2H-pyran-3-yl (3-((4-(((2R,3R,4S,5R,6R)- 6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2- carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H- pyran-3-yl)oxy)-4-oxobutanoyl)oxy)-1-(2,2-dichloroacetamido)-2- (4-nitrophenyl)propyl) succinate 13 (2R,3R)-6-(2-chloro-1-{[(1-methyl-4-propylpyrrolidin-2- yl)carbonyl]amino}propyl)-4,5-dihydroxy-2- (methylsulfanyl)tetrahydro-2H-pyran-3-yl (3S)-2- [(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel- butanedioate 20 ({[1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4- b]pyridin-6-yl)-4-oxo-1,4-dihydroquinolin-3- yl]carbonyl]oxy)methyl (2R,3R)-2-[(dichloroacetyl)amino]-3- hydroxy-3-(4-nitrophenyl)propyl rel-butanedioate 23 {[acetyl({(5R)-3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3- oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl (2R,3R)-2- [(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel- butanedioate 22 (2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4- nitrophenyl)propyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7- (octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4- dihydroquinoline-3-carboxylate 24 {[acetyl({3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3- oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl 1-cyclopropyl-6- fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4- oxo-1,4-dihydroquinoline-3-carboxylate 25 {[acetyl({3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3- oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl 1-cyclopropyl-6- fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4- dihydroquinoline-3-carboxylate 19 (2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4- nitrophenyl)propyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3- methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate 17 ({[1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4- oxo-1,4-dihydroquinolin-3-yl]carbonyl}oxy)methyl (2R,3R)-2- [(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel- butanedioate 21 rel-1-cyclopropyl-7-(1-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4- nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan- 1-oyl}octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-6-fluoro-8- methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid 18 rel-1-cyclopropyl-7-(4-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4- nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan- 1-oyl}-3-methylpiperazin-1-yl)-6-fluoro-8-methoxy-4-oxo-1,4- dihydroquinoline-3-carboxylic acid 26 rel-7-[4-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)- 4-amino-6-{[(2S)-4-amino-2-hydroxybutanoyl]amino}-3- {[(2R,3R,4S,5S,6R)-6-(aminomethyl)-3,4,5-trihydroxytetrahydro- 2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5- dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4- oxobutanoyl)oxy]methoxy}carbonyl)-3-methylpiperazin-1-yl]-1- cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3- carboxylic acid 10 7-(4-((((4-(((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4- propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2- (methylthio)tetrahydro-2H-pyran-3-yl)oxy)-4- oxobutanoyl)oxy)methoxy)carbonyl)-3-methylpiperazin-1-yl)-1- cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3- carboxylic acid 8 (2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4- propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2- (methylthio)tetrahydro-2H-pyran-3-yl 1-cyclopropyl-6-fluoro-7- (hexahydro-1H-pyrrolo[3,4-b]pyridin-6(2H)-yl)-8-methoxy-4-oxo- 1,4-dihydroquinoline-3-carboxylate 9 (2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4- propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2- (methylthio)tetrahydro-2H-pyran-3-yl 1-cyclopropyl-6-fluoro-8- methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline- 3-carboxylate 3 [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino- 3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5- hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}- 3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl ({[1-cyclopropyl-6- fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4- dihydroquinolin-3-yl]carbonyl}oxy)methyl rel-butanedioate 27 [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4-amino-6- {[(2S)-4-amino-2-hydroxybutanoyl]amino}-3-{[(2R,3R,4S,5S,6R)- 6-(aminomethyl)-3,4,5-trihydroxytetrahydro-2H-pyran-2-yl]oxy}- 2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2- yl]methyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3- methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate 7 rel-7-[1-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)- 4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5- hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}- 3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4- oxobutanoyl)oxy]methoxy}carbonyl)octahydro-6H-pyrrolo[3,4- b]pyridin-6-yl]-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4- dihydroquinoline-3-carboxylic acid 5 rel-7-[4-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)- 4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5- hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}- 3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4- oxobutanoyl)oxy]methoxy}carbonyl)-3-methylpiperazin-1-yl]-1- cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3- carboxylic acid 6 [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino- 3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5- hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}- 3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl rel-1-cyclopropyl- 6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4- oxo-1,4-dihydroquinoline-3-carboxylate 4 [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino- 3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5- hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}- 3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl rel-1-cyclopropyl- 6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4- dihydroquinoline-3-carboxylate 1 7,7′-{(2-oxo-1,3-dioxole-4,5-diyl)bis[methanediyl(3- methylpiperazine-4,1-diyl)]}bis(1-cyclopropyl-6-fluoro-8- methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid) 2 1-cyclopropyl-7-(4-{[({[1-cyclopropyl-6-fluoro-8-methoxy-7- (octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4- dihydroquinolin-3-yl]carbonyl}oxy)methoxy]carbonyl}-3- methylpiperazin-1-yl)-6-fluoro-8-methoxy-4-oxo-1,4- dihydroquinoline-3-carboxylic acid

Some compounds of the invention have at least one stereogenic center in their structure. This stereogenic center may be present in an R or S configuration, said R and S notation is used in correspondence with the rules described in Pure Appli. Chem. (1976), 45, 11-13.

The term “pharmaceutically acceptable salts” refers to salts or complexes that retain the desired biological activity of the above identified compounds and exhibit minimal or no undesired toxicological effects. The “pharmaceutically acceptable salts” according to the invention include therapeutically active, non-toxic base or acid salt forms, which the compounds of the invention are able to form.

The acid addition salt form of a compound of the invention that occurs in its free form as a base can be obtained by treating the free base with an appropriate acid such as an inorganic acid, for example, hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid and the like; or an organic acid such as for example, acetic, hydroxyacetic, propanoic, lactic, pyruvic, malonic, fumaric acid, maleic acid, oxalic acid, tartaric acid, succinic acid, malic acid, ascorbic acid, benzoic acid, tannic acid, pamoic acid, citric, methylsulfonic, ethanesulfonic, benzenesulfonic, formic acid and the like (Handbook of Pharmaceutical Salts, P. Heinrich Stahl & Camille G. Wermuth (Eds), Verlag Helvetica Chimica Acta-Zürich, 2002, 329-345).

The base addition salt form of a compound of the invention that occurs in its acid form can be obtained by treating the acid with an appropriate base such as an inorganic base, for example, sodium hydroxide, magnesium hydroxide, potassium hydroxide, calcium hydroxide, ammonia and the like; or an organic base such as for example, L-Arginine, ethanolamine, betaine, benzathine, morpholine and the like. (Handbook of Pharmaceutical Salts, P. Heinrich Stahl & Camille G. Wermuth (Eds), Verlag Helvetica Chimica Acta-Zürich, 2002, 329-345).

Compounds of the invention and their salts can be in the form of a solvate, which is included within the scope of the present invention. Such solvates include for example hydrates, alcoholates and the like.

In still another embodiment of the invention, there are provided methods for treating or preventing eye conditions such as: conjunctivitis, keratitis, blepharitis, dacyrocystitis, hordeolum, corneal ulcers, anterior blepharitis, endophthalmitis, posterior blepharitis, meibomian gland dysfunction, dry eye disease (keratocojunctivitis sicca) ocular pain, ocular pain and inflammation post-ocular surgery, bacterial conjunctivitis, anterior uveitis, in a patient suffering thereof.

Such methods can be performed, for example, by administering to a subject in need thereof a therapeutically effective amount of at least one compound of the invention, or any combination thereof, or pharmaceutically acceptable salts, hydrates, solvates, crystal forms thereof.

The present invention concerns the use of a hybrid drug of the invention or a pharmaceutically acceptable salt thereof, for the manufacture of a medicament for the treatment of conjunctivitis, keratitis, endophthalmitis, blepharitis, dacyrocystitis, hordeolum, corneal ulcers, anterior blepharitis, posterior blepharitis, meibomian gland dysfunction, dry eye disease (keratocojunctivitis sicca) ocular pain, ocular pain and inflammation post-ocular surgery, bacterial conjunctivitis, anterior uveitis.

The actual amount of the hybrid drug to be administered in any given case will be determined by a physician taking into account the relevant circumstances, such as the severity of the condition, the age and weight of the patient, the patient's general physical condition, the cause of the condition, and the route of administration.

In another embodiment of the invention, there are provided pharmaceutical compositions including at least one compound of the invention in a pharmaceutically acceptable carrier thereof. The phrase “pharmaceutically acceptable” means the carrier, diluent or excipient must be compatible with the other ingredients of the formulation and not deleterious to the recipient thereof.

Pharmaceutical compositions of the present invention can be used in the form of a solid, a solution, an emulsion, a dispersion, a patch, a micelle, a liposome, and the like, wherein the resulting composition contains one or more compounds of the present invention, as an active ingredient, in admixture with an organic or inorganic carrier or excipient suitable for enteral or parenteral applications. Invention compounds may be combined, for example, with the usual non-toxic, pharmaceutically acceptable carriers for tablets, pellets, capsules, suppositories, solutions, emulsions, suspensions, and any other form suitable for use. The carriers which can be used include glucose, lactose, gum acacia, gelatin, mannitol, starch paste, magnesium trisilicate, talc, corn starch, keratin, colloidal silica, potato starch, urea, medium chain length triglycerides, dextrans, and other carriers suitable for use in manufacturing preparations, in solid, semisolid, or liquid form. In addition auxiliary, stabilizing, thickening and coloring agents and perfumes may be used. Invention compounds are included in the pharmaceutical composition in an amount sufficient to produce the desired effect upon the process or disease condition.

The compounds of the invention may be administered as pharmaceutical compositions in a form suitable for topical use, for example, as oily suspensions, as solutions or suspensions in aqueous liquids or nonaqueous liquids, or as oil-in-water or water-in-oil liquid emulsions. Pharmaceutical compositions may be prepared by combining a therapeutically effective amount of at least one compound according to the present invention, or a pharmaceutically acceptable salt thereof, as an active ingredient with conventional ophthalmically acceptable pharmaceutical excipients and by preparation of unit dosage suitable for topical ocular use. The therapeutically efficient amount typically is between about 0.001 and about 5% (w/v), preferably about 0.001 to about 2.0% (w/v) in liquid formulations.

For ophthalmic application, preferably solutions are prepared using a physiological saline solution as a major vehicle. The pH of such ophthalmic solutions should preferably be maintained between 4.5 and 8.0 with an appropriate buffer system, a neutral pH being preferred but not essential. The formulations may also contain conventional pharmaceutically acceptable preservatives, stabilizers and surfactants.

Preferred preservatives that may be used in the pharmaceutical compositions of the present invention include, but are not limited to, benzalkonium chloride, chlorobutanol, thimerosal, phenylmercuric acetate and phenylmercuric nitrate.

A preferred surfactant is, for example, Tween 80. Likewise, various preferred vehicles may be used in the ophthalmic preparations of the present invention. These vehicles include, but are not limited to, polyvinyl alcohol, povidone, hydroxypropyl methyl cellulose, poloxamers, carboxymethyl cellulose, hydroxyethyl cellulose cyclodextrin and purified water.

Tonicity adjustors may be added as needed or convenient. They include, but are not limited to, salts, particularly sodium chloride, potassium chloride, mannitol and glycerin, or any other suitable ophthalmically acceptable tonicity adjustor.

Various buffers and means for adjusting pH may be used so long as the resulting preparation is ophthalmically acceptable. Accordingly, buffers include acetate buffers, citrate buffers, phosphate buffers and borate buffers. Acids or bases may be used to adjust the pH of these formulations as needed.

In a similar manner an ophthalmically acceptable antioxidant for use in the present invention includes, but is not limited to, sodium metabisulfite, sodium thiosulfate, acetylcysteine, butylated hydroxyanisole and butylated hydroxytoluene.

Other excipient components which may be included in the ophthalmic preparations are chelating agents. The preferred chelating agent is edentate disodium, although other chelating agents may also be used in place of or in conjunction with it.

The ingredients are usually used in the following amounts:

Ingredient Amount (% w/v) active ingredient about 0.001-5 preservative     0-0.10 vehicle   0-40 tonicity adjustor   0-10 buffer 0.01-10 pH adjustor q.s. pH 4.5-7.8 antioxidant as needed surfactant as needed purified water to make 100%

The actual dose of the active compounds of the present invention depends on the specific compound, and on the condition to be treated; the selection of the appropriate dose is well within the knowledge of the skilled artisan. The ophthalmic formulations of the present invention are conveniently packaged in forms suitable for metered application, such as in containers equipped with a dropper, to facilitate application to the eye. Containers suitable for dropwise application are usually made of suitable inert, non-toxic plastic material, and generally contain between about 0.5 and about 15 ml solution. One package may contain one or more unit doses. Especially preservative-free solutions are often formulated in non-resealable containers containing up to about ten, preferably up to about five units doses, where a typical unit dose is from one to about 8 drops, preferably one to about 3 drops. The volume of one drop usually is about 20-35 μl. Since individual subjects may present a wide variation in severity of symptoms and each drug has its unique therapeutic characteristics, the precise mode of administration and dosage employed for each subject is left to the discretion of the practitioner.

The patient may be administered the compound orally in any acceptable form, such as a tablet, liquid, capsule, powder and the like, or other routes may be desirable or necessary, particularly if the patient suffers from nausea. Such other routes may include, without exception, transdermal, parenteral, subcutaneous, intranasal, via an implant stent, intrathecal, intravitreal, topical to the eye, back to the eye, intramuscular, intravenous, and intrarectal modes of delivery. Additionally, the formulations may be designed to delay release of the active compound over a given period of time, or to carefully control the amount of drug released at a given time during the course of therapy.

Pharmaceutical compositions containing invention compounds may be in a form suitable for oral use, for example, as tablets, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules, emulsions, hard or soft capsules, or syrups or elixirs. Compositions intended for oral use may be prepared according to any method known in the art for the manufacture of pharmaceutical compositions and such compositions may contain one or more agents selected from the group consisting of a sweetening agent such as sucrose, lactose, or saccharin, flavoring agents such as peppermint, oil of wintergreen or cherry, coloring agents and preserving agents in order to provide pharmaceutically elegant and palatable preparations. Tablets containing invention compounds in admixture with non-toxic pharmaceutically acceptable excipients may also be manufactured by known methods. The excipients used may be, for example, (1) inert diluents such as calcium carbonate, lactose, calcium phosphate or sodium phosphate; (2) granulating and disintegrating agents such as corn starch, potato starch or alginic acid; (3) binding agents such as gum tragacanth, corn starch, gelatin or acacia, and (4) lubricating agents such as magnesium stearate, stearic acid or talc. The tablets may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate may be employed.

In some cases, formulations for oral use may be in the form of hard gelatin capsules wherein the invention compounds are mixed with an inert solid diluent, for example, calcium carbonate, calcium phosphate or kaolin. They may also be in the form of soft gelatin capsules wherein the invention compounds are mixed with water or an oil medium, for example, peanut oil, liquid paraffin or olive oil.

The compounds and pharmaceutical compositions described herein are useful as medicaments in mammals, including humans, for treatment of diseases and/or alleviations of conditions such as conjunctivitis, keratitis, blepharitis, endophthalmitis, dacyrocystitis, hordeolum, corneal ulcers, anterior blepharitis, posterior blepharitis, meibomian gland dysfunction, dry eye disease (keratocojunctivitis sicca) ocular pain, ocular pain and inflammation post-ocular surgery, bacterial conjunctivitis, anterior uveitis, post-surgical inflammation, inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe, such as allergic conjunctivitis, ocular rosacea, blepharitis, meibomian gland dysfunction, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitis, corneal injury from chemical radiation, or thermal burns, penetration of foreign bodies, allergy, and combinations thereof.

Thus, in further embodiments of the invention, there are provided methods for treating conjunctivitis, keratitis, blepharitis, dacyrocystitis, hordeolum, corneal ulcers, anterior blepharitis, endophthalmitis, posterior blepharitis, meibomian gland dysfunction, dry eye disease (keratocojunctivitis sicca) ocular pain, ocular pain and inflammation post-ocular surgery, bacterial conjunctivitis, anterior uveitis, post-surgical inflammation, inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe, such as allergic conjunctivitis, ocular rosacea, blepharitis, meibomian gland dysfunction, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitis, corneal injury from chemical radiation, or thermal burns, penetration of foreign bodies, allergy, and combinations thereof.

Such methods can be performed, for example, by administering to a subject in need thereof a pharmaceutical composition containing a therapeutically effective amount of at least one invention compound. As used herein, the term “therapeutically effective amount” means the amount of the pharmaceutical composition that will elicit the biological or medical response of a subject in need thereof that is being sought by the researcher, veterinarian, medical doctor or other clinician. In some embodiments, the subject in need thereof is a mammal. In some embodiments, the mammal is human.

It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention claimed. As used herein, the use of the singular includes the plural unless specifically stated otherwise.

The present invention concerns also processes for preparing the hybrid compounds disclosed herein. The hybrid compounds according to the invention can be prepared analogously to conventional methods as understood by the person skilled in the art of synthetic organic chemistry. The synthetic scheme set forth below, illustrates how compounds according to the invention can be made. Those skilled in the art will be able to routinely modify and/or adapt the following schemes to synthesize any compounds of the invention.

It will be readily apparent to those skilled in the art that some of the compounds of the invention may contain one or more asymmetric centers, such that the compounds may exist in enantiomeric as well as in diastereomeric forms. Unless it is specifically noted otherwise, the scope of the present invention includes all enantiomers, diastereomers and racemic mixtures. Some of the compounds of the invention may form salts with pharmaceutically acceptable acids or bases, and such pharmaceutically acceptable salts of the compounds described herein are also within the scope of the invention.

The present invention includes all pharmaceutically acceptable isotopically enriched compounds. Any compound of the invention may contain one or more isotopic atoms enriched or different than the natural ratio such as deuterium ²H (or D) in place of hydrogen ¹H (or H) or use of ¹³C enriched material in place of ¹²C and the like. Similar substitutions can be employed for N, O and S. The use of isotopes may assist in analytical as well as therapeutic aspects of the invention. For example, use of deuterium may increase the in vivo half-life by altering the metabolism (rate) of the compounds of the invention. These compounds can be prepared in accord with the preparations described by use of isotopically enriched reagents.

As will be evident to those skilled in the art, individual isomeric forms can be obtained by separation of mixtures thereof in conventional manner. For example, in the case of diasteroisomeric isomers, chromatographic separation may be employed.

Compound names were generated with ACDLabs version 12.5 or ChemBioDraw Ultra version 12.0.2.

In general, characterization of the compounds is performed according to the following methods. Proton nuclear magnetic resonance (¹H NMR) and carbon nuclear magnetic resonance (¹³C NMR) spectra were recorded on a Varian 300 or 600 MHz spectrometer in deuterated solvent. Chemical shifts were reported as δ (delta) values in parts per million (ppm) relative to tetramethylsilane (TMS) as an internal standard (0.00 ppm) and multiplicities were reported as s, singlet; d, doublet; t, triplet; q, quartet; m, multiplet; br, broad. Data were reported in the following format: chemical shift (multiplicity, coupling constant(s) J in hertz (Hz), integrated intensity). The mass spectrometry data were determined on a Shimadzu LCMS-IT-TOF instrument.

The formation of the hybrid compounds was checked by ¹H-NMR by comparing the chemical shifts of protons H^(a), H^(b), H^(c) and/or H^(d) from the antibiotic molecule with the chemical shifts of these same protons on the newly formed hybrid drug noted H^(a)*, H^(b)*, H^(c)* and/or H^(d)* wherein “*” indicates the hybrid drug. Applicants have marked with arrows the location of these protons and the reaction site of the pro-drug moiety, where available. Each scheme shows the formation of the new hybrid drug. Each table describes the results for the new hybrid drug and the linker number, where existing. The linker and pro-drug moiety numbers are as described in Table 1 and 2 respectively.

The following examples are for illustrative purposes only and are not intended, nor should they be construed as limiting the invention in any manner. Those skilled in the art will appreciate that variations and modifications of the following examples can be made without exceeding the spirit or scope of the invention.

EXAMPLES

Two molecules of gatifloxacin reacted to form the following hybrid compound as shown in Scheme 2 with the results described in Table 4.

TABLE 4 Comp No H^(b*) H^(b*) Linker δ δ No Structure (ppm) (ppm) Mass 1 L12

8.82 8.76 861 (MH⁺) Gatifloxacin reacted with one molecule of moxifloxacin to form the following hybrid compounds as shown in Scheme 3 with the results described in Table 5.

TABLE 5 Comp No. H^(b*) Hd* Linker δ δ Mass No. Structure (ppm) (ppm) MNa+ 2 L9

8.82 8.81 833

Tobramycin reacted with one molecule of Gatifloxacin to form the following hybrid compounds as shown in Scheme 4 with the results described in Table 6; and as shown in Scheme 5 with the results described in Table 7; and as shown in Scheme 6 with the results described in Table 8.

TABLE 6 Comp No. H^(a*) H^(b*) Linker δ δ Mass No. Structure (ppm) (ppm) MNa+ 3 L47

8.88 7.89 978

TABLE 7 H^(b*) H^(a*) Compd δ δ Mass No. Structure (ppm) (ppm) MH+ 4

8.83 7.85 825

TABLE 8 Comp No. H^(a*) H^(b*) Linker δ δ Mass No. Structure ppm ppm MH+ 5 L52

8.88 7.84 999

Moxifloxacin reacted with one molecule of Tobramycin to form the following hybrid compounds as shown in Scheme 7 with the results described in Table 9; and as shown in Scheme 8 with the results described in Table 10.

TABLE 9 H^(a*) H^(b*) Comp δ δ Mass No. Structure (ppm) (ppm) MH+ 6

8.80 7.75 851

TABLE 10 Comp No. H^(a*) H^(b*) Linker δ δ Mass No Structure (ppm) (ppm) MH+ 7 L52

8.87 7.72 1025

-   -   Moxifloxacin reacted with one molecule of Clindamycin to form         the following hybrid compounds as shown in Scheme 9 with the         results described in Table 11.

TABLE 11 H^(a*) Hb* H^(c*) Comp δ δ δ Mass No. Structure (ppm) (ppm) (ppm) MNa+ 8

5.36 8.82 7.75 830

Gatifloxacin reacted with one molecule of Clindamycin to form the following hybrid compounds as shown in Scheme 10 with the results described in Table 12; and as shown in Scheme 11 with the results described in Table 13.

TABLE 12 H^(a*) H^(b*) H^(c*) Comp. δ δ δ Mass No. Structure ppm ppm ppm MNa+ 9

5.36 8.84 7.86 804

TABLE 13 Comp No. H^(a*) Hb* Hc* Linker δ δ δ Mass No. Structure ppm ppm ppm MNa+ 10 L52

7.86 8.87 5.15 954

Clindamycin reacted with one molecule of chloramphenicol to form the following hybrid compounds as shown in Scheme 12 with the results described in Table 14.

TABLE 14 Comp No. H^(c*) Ha* Linker δ δ No. Structure (ppm) (ppm) Mass 11 L53

5.17 6.24 882 MH+ 12 L54

5.16 6.23 882 MNa+ 13 L55

5.17 6.21 853 MNa+ 14 L90

5.41 6.21 901 MNa+ 15 L65

5.13 6.17 940 MNa+

Two molecules of clindamycin reacted with one molecule of chloramphenicol to form the following hybrid compounds as shown in Scheme 13 with the results described in Table 15.

TABLE 15 Comp No. H^(c*) Ha* Linker 1 δ δ Linker2 Structure (ppm) (ppm) Mass 16 L₁55 L₂55

5.16 6.25 1335 MH−

Gatifloxacin reacted with one molecule of chloramphenicol to form the following hybrid compounds as shown in Scheme 14 with the results described in Table 16; and as shown in Scheme 15 with the results described in Table 17; as shown in Scheme 16 with the results described in Table 18.

TABLE 16 Comp No. H^(c*) Hb* Ha* Linker δ δ δ No. Structure (ppm) (ppm) (ppm) Mass 17 L47

6.24 8.75 7.77 832 MNa+

TABLE 17 Comp No. H^(c*) Hb* Ha* Linker δ δ δ No. Structure (ppm) (ppm) (ppm) Mass 18 L52

6.21 8.85 7.79 854 MH−

TABLE 18 H^(c*) Hb* Ha* Comp δ δ δ No. Structure (ppm) (ppm) (ppm) Mass 19

6.27 8.68 7.78 680 MH+

Moxifloxacin reacted with one molecule of Chloramphenicol to form the following hybrid compounds as shown in Scheme 17 with the results described in Table 19; and as shown in Scheme 18 with the results described in Table 20; and as shown in Scheme 19 with the results described in Table 21.

TABLE 19 Comp No. H^(c*) H^(b*) H^(a*) Linker δ δ δ No. Structure (ppm) (ppm) (ppm) Mass 20 L47

6.24 8.71 7.51 858 MNa+

TABLE 20 Comp No. H^(c*) H^(b*) H^(a*) Linker δ δ δ No. Structure (ppm) (ppm) (ppm) Mass 21 L52

6.21 8.80 7.64 902 MH+

TABLE 21 H^(c*) H^(b*) H^(a*) Comp δ δ δ No. Structure (ppm) (ppm) (ppm) Mass 22

6.27 8.62 7.51 728 MNa+

Linozolid reacted with one molecule of chloramphenicol to for the following hybrid compounds and as shown in Scheme 20 with the results described in Table 22.

TABLE 22 Comp H^(a*) No. δ Linker Structure (ppm) Mass 23 L52

6.21 838 MNa+

Linozolid reacted with one molecule of moxifloxacin to for the following hybrid compounds and as shown in Scheme 21 with the results described in Table 22.

TABLE 23 Comp No. H^(b*) H^(a*) Linker δ δ No. Structure (ppm) (ppm) Mass 24 L46

8.76 7.53 817 MNa+

Linozolid reacted with one molecule of gatifloxacin to for the following hybrid compounds and as shown in Scheme 22 with the results described in Table 23.

TABLE 24 Comp H^(b*) H^(a*) No. δ δ Linker Structure (ppm) (ppm) Mass 25 L46

8.81 7.71 769 MNa+

Amikacin reacted with one molecule of moxifloxacin to form the following hybrid compounds and as shown in Scheme 23 with the results described in Table 25; and as shown in Scheme 24 with the results described in Table 26.

TABLE 25 Comp No. H^(b*) H^(a*) Linker δ δ No. Structure (ppm) (ppm) Mass 26 L52

8.88 7.84 1117 MNa+

TABLE 26 H^(b*) H^(a*) Comp δ δ No. Structure (ppm) (ppm) Mass 27

8.81 7.93 965 MNa+

In Vitro Metabolic Stability in Human Recombinant Carboxylesterases

Human recombinant carboxylesterases were purchased from a commercial vendor (BD Gentest™, Bedford, Massachusettes). All metabolic stability experiments were performed in triplicate in 96-well plate format. The final incubation mixture contained 1 μM test compound and 0.1 mg/mL human recombinant carboxylesterase mixture in a final volume of 0.5 mL 0.1M potassium phosphate buffer (pH=6.0). The final percentage of solvent in the incubation was less than 1.0% to prevent inhibition of enzymatic activity. Following a pre-incubation at 37° C., test article was added to initiate the reaction. At designated time points (typically 120 minutes to capture the linear range of metabolite formation), 0.05 mL aliquots were removed from the incubation mixtures using a clean pipet tip and immediately placed in organic solvent to stop any esterase activity. The hydrolysis to the metabolites was confirmed to be due to esterase activity and not chemical lability.

The samples were analyzed by liquid chromatography with mass spectrometry (LC-MS/MS) detection to determine the metabolite concentrations resulting from the metabolism of the hybrid compounds. Internal standards were used to compensate for variability from sample processing, chromatographic elution, mass spectrometer response and ion suppression by matrix components.

Results

Table 27 Lists the rate of metabolite formation in human recombinant

TABLE 27 Rate of Rate of formation formation Comp. Metabolite 1 Metabolite 2 No. Structure (nM/min/mg) (nM/min/mg) 25

9.26 ± 0.51 Linozolid 8.27 ± 1.17 Gatifloxacin 24

5.45 ± 0.29 Linozolid 4.88 ± 0.01 Moxifloxacin

The data demonstrate that linkage of two antibiotics (e.g. linozolid, gatifloacin, and moxifloxacin) as a single hybrid compound was hydrolyzed enzymatically in human recombinant carboxylesterases to their respective individual antibiotic drugs. 

What is claimed is:
 1. A hybrid drug comprising at least two antibiotic moieties, or a pharmaceutical salt thereof, which are connected via two covalent bonds to a linker such that said covalent bonds degrade in vivo to yield the respective antibiotics independently.
 2. The hybrid drug according to claim 1 wherein the antibiotic moieties are selected from the group consisting of levofloxacin, moxifloxacin, gatifloxacin, gemifloxacin, trovafloxacin, ofloxacin, ciprofloxacin, sparfloxacin, grepafloxacin, norfoxacin, enoxacin, lomefloxacin, fleroxacin, tosufloxacin, prulifloxacin, pazufloxacin, clinafloxacin, garenoxacin, sitafloxacin, loracarbef, cephalexin, cefuroxime, ceftriaxone, ceftaxime, ceftizoxime, ceftibuten, ceftazidime, cefprozil, cefpodoxime, cefoxitin, cefotetan, cefotaxime, cefoperazone, cefixime, cefepime, cefditoren, cefdinir, cefoperaxone, moxalactam, cefazolin, cefamandole, cefadroxil, cefaclor, cephalothin, cephradine, cephacetrile, cephalothin, chloramphenicol, tobramycin, streptomycin, gentamicin, kanamycin, amikacin, netilmicin, penicillin g, ticarcillin, methicillin, phenthicillin, cloxacillin, dicloxacillin, nafcillin, oxacillin, erythromycin and azithromycin.
 3. The hybrid compound according to claim 1, wherein said linker comprises an ester, a carboxylate, a carbonyl, a carbonate, an amido, a carbamate, a ketone, an amino, an oxo, an ethylene glycol, a polyethylene glycol or an alkylene moiety.
 4. The hybrid compound according to claim 1, wherein said antibiotics are different.
 5. The hybrid compound according to claim 1 comprising a linker having two bonds, wherein said bonds are asymmetrically degraded in vivo to release the two antibiotic moieties.
 6. The hybrid compound according to claim 1, selected from: 1-cyclopropyl-7-(4-{[({[1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinolin-3-yl]carbonyl}oxy)methoxy]carbonyl}-3-methylpiperazin-1-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; rel-7-[4-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4-oxobutanoyl)oxy]methoxy}carbonyl)-3-methylpiperazin-1-yl]-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl({[1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinolin-3-yl]carbonyl}oxy)methyl rel-butanedioate; [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-d i hydroxytetrahydro-2H-pyran-2-yl]methyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; rel-7-[1-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4-oxobutanoyl)oxy]methoxy}carbonyl)octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl]-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; 3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl 1-cyclopropyl-6-fluoro-7-(hexahydro-1H-pyrrolo[3,4-b]pyridin-6(2H)-yl)-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylate; 4-(((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl)oxy)-4-oxobutyl(2-(2,2-dichloroacetamido)-3-hydroxy-3-(4-nitrophenyl)propyl)succinate; 1-((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl) 5-(3-(2,2-dichloroacetamido)-3-hydroxy-2-(4-nitrophenyl)propyl)2-aminopentanedioate; (2R,3R)-6-(2-chloro-1-{[(1-methyl-4-propylpyrrolidin-2-yl)carbonyl]amino}propyl)-4,5-dihydroxy-2-(methylsulfanyl)tetrahydro-2H-pyran-3-yl(3S)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel-butanedioate; 3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl(2-(2,2-dichloroacetamido)-3-hydroxy-3-(4-nitrophenyl)propyl)terephthalate; 2-amino-3-(2-(2,2-dichloroacetamido)-3-hydroxy-3-(4-nitrophenyl)propoxy)-3-oxopropyl((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl)succinate; 7-(4-((((4-(((2R,3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl)oxy)-4-oxobutanoyl)oxy)methoxy)carbonyl)-3-methylpiperazin-1-yl)-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; 3R,4S,5R,6R)-6-((1S)-2-chloro-1-(1-methyl-4-propylpyrrolidine-2-carboxamido)propyl)-4,5-dihydroxy-2-(methylthio)tetrahydro-2H-pyran-3-yl 1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; rel-1-cyclopropyl-7-(4-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4-nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan-1-oyl}-3-methylpiperazin-1-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; ({[1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinolin-3-yl]carbonyl}oxy)methyl(2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel-butanedioate; (2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; rel-1-cyclopropyl-7-(1-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4-nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan-1-oyl}octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; (2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; rel-1-cyclopropyl-7-(1-{(11R)-14,14-dichloro-11-[(R)-hydroxy(4-nitrophenyl)methyl]-5,8,13-trioxo-2,4,9-trioxa-12-azatetradecan-1-oyl}octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; {[acetyl({(5R)-3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3-oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl(2R,3R)-2-[(dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl rel-butanedioate; {[acetyl({3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3-oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl 1-cyclopropyl-6-fluoro-8-methoxy-7-(octahydro-6H-pyrrolo[3,4-b]pyridin-6-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; {[acetyl({3-[3-fluoro-4-(morpholin-4-yl)phenyl]-2-oxo-1,3-oxazolidin-5-yl}methyl)carbamoyl]oxy}methyl 1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate; rel-7-[4-({[(4-{[(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4-amino-6-{[(2S)-4-amino-2-hydroxybutanoyl]amino}-3-{[(2R,3R,4S,5S,6R)-6-(aminomethyl)-3,4,5-trihydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methoxy}-4-oxobutanoyl)oxy]methoxy}carbonyl)-3-methylpiperazin-1-yl]-1-cyclopropyl-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid; and [(2R,3S,4S,5R,6S)-4-amino-6-{[(1S,2S,3R,4S,6R)-4-amino-6-{[(2S)-4-amino-2-hydroxybutanoyl]amino}-3-{[(2R,3R,4S,5S,6R)-6-(aminomethyl)-3,4,5-trihydroxytetrahydro-2H-pyran-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-3,5-dihydroxytetrahydro-2H-pyran-2-yl]methyl rel-1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-1,4-dihydroquinoline-3-carboxylate.
 7. The hybrid compound according to claim 1, comprising an antibiotic moiety selected from: gatifloxacin, moxifloxacin, tobramycin, clindamycin, chloramphenicol, linozolid and amikacin.
 8. A method comprising administrating to an eye of a mammal a pharmaceutical composition comprising a therapeutically active amount of a hybrid drug comprising at least two antibiotic moieties, which are connected via two covalent bonds to a linker such that said covalent bonds degrade in vivo to yield the two antibiotics, wherein each bond is an ester bond or an amide, wherein said method is effective in the treatment of a bacterial infection affecting said eye.
 9. The method according to claim 8 wherein said hybrid drug has topical antibiotic activity upon a surface of an eye, and wherein the hybrid drug degrades on said surface into active antibiotic which are capable of penetrating beyond tissue of said surface.
 10. The method according to claim 8, wherein the bacterial infection is selected from: conjunctivitis, keratitis, blepharitis, dacyrocystitis, hordeolum, corneal ulcers, anterior blepharitis, posterior blepharitis, endophthalmitis, meibomian gland dysfunction, red eye, hyperemia, dry eye disease (keratocojunctivitis sicca) ocular pain, ocular pain and inflammation post-ocular surgery, bacterial conjunctivitis, anterior uveitis, post-surgical inflammation, inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe, such as allergic conjunctivitis, ocular rosacea, blepharitis, meibomian gland dysfunction, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitis, corneal injury from chemical radiation, or thermal burns, penetration of foreign bodies and allergy.
 11. The method according to claim 8, wherein the mammal is a human.
 12. A pharmaceutical composition comprising a hybrid drug comprising at least two antibiotic moieties, which are connected via two covalent bonds to a linker such that said covalent bonds degrade in vivo to yield the two antibiotics, and wherein each bond is an ester bond or an amide bond, and wherein said pharmaceutical composition is formulated for topical ophthalmic administration.
 13. The hybrid drug according to claim 1 wherein, the two antibiotic moieties are selected from: gatifloxacin, moxifloxacin, tobramycin, clindamycin, chloramphenicol, linozolid and amikacin. 